:

:



6





20-30

Trends in overweight in children 1970-2000

Prevalence %

35
30

Australia

25

Brazil

20

Canada
China

15

Spain

10

UK
USA

5
0
1970

1980

1990

2000

Lobstein T. childhood @iotf.org

12 30


6

(1)

3 (school
food programs)


(nutrition education)
(physical education
and physical activity of children)

(school food programs)

(1)

 The U.S. Department of Agriculture (USDA) School Nutrition

Programs () The
National School Lunch Program,() The School Breakfast
Program,() Afterschool Snacks,() Competitive
Food
The National School Lunch Program1 The School Breakfast
Program2 Afterschool Snacks3



(The dietary Guideline for all American)

competitive food

USDA
competitive food

(vending machine) competitive food


USDA competitive food
(Foods
of minimal nutritional value) /(FMNV)
(FMNV)

1

Food and Nutrition Service, USDA. National School Lunch Program: Factsheet.
http://www.fns.usda.gov/cnd/Lunch/AboutLunch/NSLPFactSheet.pdf Federal food programs.
School Lunch program. www.frac.org/html/federal_food_programs/programs/nslp.html
2
Food and Nutrition Service, USDA. National School Breakfast Program: Factsheet.
http://www.fns.usda.gov/cnd/Breakfast/AboutBFast/NSLPFactSheet.pdf Federal food programs.
School breakfast program. www.frac.org/html/federal_food_programs/programs/sbp.html
3
Food and Nutrition Service, USDA. National School Breakfast Program: Factsheet.
http://www.fns.usda.gov/cnd/Afterschool/factSheet.htm

(1)

 competitive
foods
FMNV
20%
Pizza Hut, Taco Bell

competitive foods
competitive foods
(Competitive Food Standards Recommendations)4

50
USDA
School Nutrition Programs
Center for Science in the Public interest (CSPI)5

Center for Science in the Public interest (CSPI), School Foods Tool kit partI, how to

improve school food and beverage http://www.cspinet.org/schoolfoodkit/school_foods_kit_part1.pdf

Center for Science in the Public interest (CSPI), School Foods Tool kit partII, materials and
policies http://www.cspinet.org/schoolfoodkit/school_foods_kit_part2.pdf
5

(1)

School nutrition program

competitive foods
Thomas Robinson, Director of the
Center for Healthy Weight at Lucile Packard Childrens Hospital at Stanford University
School of Medicine
1. USDA competitive foods

2.
(moderate to vigorous physical activity) 30

3.


2


5 A Day Program6
5-9


1991 the Produce for
6

Dole 5 a day.http://www.dole5aday.com/

(1)

Better Health Foundation the

Surgeon General of the United States, The Centers for Disease Control and Prevention,
The U.S. Public Health Service, USDA, The American Cancer Society, The American
Institute for Cancer Research the American Heart Association


5 A Day 16
The Fresh Fruits and Vegetable Program (FFVP)7
Child Nutrition Program
2002 1 2004
9
Indiana, Iowa, Michigan Ohio

Ditch the fizz Program 8

ditch the fizz
1 Christchurch
2
0.6
(diet) 0.2%
0.2
7.5%
(nutrition education)
(physical education and physical activity of children)



7

The Fresh Fruits and Vegetable Program (FFVP). http://www.doe.state.in.us/food

/freshfruit_veg_program.html
8
Ditch the fizz Program. http://www.commercialfreechildhood.org/news /articles/antisodaprogram.htm

(1)


Team Nutrition
Program USDA
USDA
Team Nutrition
Making It Happen :
School Nutrition Success Stories9

USDA


Making It Happen : School Nutrition Success
Stories (1)
competitive foods (2)
(3)
(4)
(5) competitive foods
(6)

Coordinated School Health Programs (CSHP)10 National Center
for Chronic Disease Prevention and Health Promotion (CDC)




8
1. Health education ()
2. Physical education ()
3. Health services ()
9

FNS:USDA. Team nutrition. http://www.fns.usda.gov/tn/

10

CDC. Coordinated school health program. http://www.cdc.gov/HealthyYouth/CSHP/

(1)

4. Nutrition services ()
5. Health promotion for staff ()
6. Counseling and psychological services (
)
7. Health school environment ()
8. Parent/ Community involvement ()

The National Association State Boards of Education (NASBE) The National School
Boards Association (NSBA)
School health program The Division of
Adolescent and School Health (DASH) The Centers for disease control and
prevention (CDC) A school health policy guide ,

Healthy Schools : Fit, Healthy, and Ready to learn A
School health policy guide11
Sample Policies to
encourage Healthy eating ()


11

(1) Healthy Schools : Fit, Healthy, and Ready to learn :A School health policy

guide. http://www.nasbe.org/HealthySchools/ (2) state-level school health policy.

http://www.nasbe.org/HealthySchools/States/State_Policy.asp

(1)

(1)

(2)
(3)

(Sample Policies to encourage Healthy eating )

(1) 6



(food labels)

(2)

(model of healthy eating habit)

(1)

10

(3) (The food service program)

(4)

10 20

(5) (other food choices at school)

(nutritious and appealing foods)

30

(6)
(school counselors) (school health service)


(1)

11

(1)

12



Booth 12 2001
15 % 5-10%

2002 A National
Obesity Taskforce
Healthy Weight 2008

12

Melissa A. Wake and Zoe McCallum. Secondary prevention of overweight in primary school

children: what place for general practice? in MJA 2004 ; 181 (2) : 82-84.

(1)

13



Tackling childhood obesity: an Australian intervention model
Center for Health Promotion, Womens and Childrens
Hospital13

4
1. (Guidelines, regulations
and
policies)

2. ( Community and Parental Support)

YMCA

13

Dr. Alison M Smith, Melanie Smith, Leanne Kennett, Tackling childhood obesity: an Australian

intervention model, Centre for Health Promotion, Womens and Childrens Hospital, Adelaide.
http://www.chdf.org.au/i-cms_file?page=811/Obesityposterfinal.pdf

(1)

14

3.

4.

NSW Government Action Plan (2003-2007)14

New South Wales

2001

2002 New South Wales
Action Plan



2007
Healthy Eating Policy Development A Guide for School15
8 Central Zone Queensland



(1)
(2)
14

NSW Government Action Plan 2003-2007

http://www.health.nsw.gov.au/obesity/adult/gap/ObesityActionPlan.pdf
15
Queensland Government, Queensland Health, Healthy Eating Policy Development : A Guide for
schools. http://www.health.qld.gov.au/phs/Documents/cphun/27301.pdf

(1)

15



(3)

(4)

(5)



Fresh for Kids ()




Fruit Tag

Food for Health16 ()

Department of Health and ageing

The Act Health promoting school canteen project17 (
)

16

Australian Government, Department of Health and Ageing, National Health and Medical Research

Council, Food for Health

17
Department of education & Training, Food & Nutrition, Department of education & Training,
http://activated.decs.act.gov.au/hps/resources/foodnutrition.htm

(1)

16

Move it Groove it-physical activity in primary school 18

New South Wales

intervention

18

NSW Health working as a team, Move it Groove it Physical activity in primary schools summary

report http://www.health.nsw.gov.au/pubs/m/pdf/move_groove.pdf

(1)

17

3 1980
1991
Trim and Fit Program 1992

weight training
19
19

(1) Curriculum Planning and Development Division, Ministry of Education

(Singapore) in collaboration with School Health Services, Ministry of Health (Singapore) 11/00, Trim
and Fit (TAF) Programme, http://www.moe.gov.sg/cpdd/pe/taf/doc/Rationale.pdf (2) Curriculum
Planning and Development Division, Ministry of Education (Singapore) in collaboration with School
Health Services, Ministry of Health (Singapore) 11/00, Why be Trim and Fit, (3) Health Promotion
Board, A Holistic Approach to achieving optimal health the Singapore experience, 15-17 December
2004, Taipei Taiwan.
http://www.come2meet.com/healthycity/ppt/17_Theresa%20Yoong.pdf

(1)

18

 TAF
(wristband) Im
Trim and Fit (1)
(Overweight) 5
(2)
health center 3.
TAF (wristbands)
calorie cash
(4)

10 Trim and Fit Programme

14 10 2003
intervention 20

School
Tuckshop Programme21 2001
3

(Model School Tuckshop)
workshop

20

(1) C M Toh, S K Chew, C C Tan, Prevention and Control of Non Communicable

Diseases in Singapore : A Review of National Health Promotion Programmes, Singapore Med J 2002
Vol 43(7) : 333-339 http://www.sma.org.sg/smj/4307/4307a1.pdf (2)Cheong Mui Toh, Jeffery
Cutter, Suok Kai Chew, School based intervention has reduced obesity in Singapore,
BMJ2002;324:427 (16 February).
21
NSW Health, Kids Healthy Food and Activity Guide,
http://www3.health.nsw.gov.au/cihfap/form/surveyform.cfm

(1)

19


Health Promotion Board (2004)
7
1. 8 /100 . (sugar-sweetened
drinks)

8 /100 . /

2. (preserved
meat) 1

3.
4.
(skinless poultry and lean meat)
5. 2
1
6. 2
7.
3 2001-2003


236
140 Health
Promoting Board22 1 4
7 1 2
5 7

22

Health Promotion Board, A Holistic Approach to achieving optimal health the Singapore experience,

15-17 December 2004, Taipei Taiwan.

http://www.come2meet.com/healthycity/ppt/17_Theresa%20Yoong.pdf

(1)

20


Health
Club Schools weight loss club



Trim and Fit

(1)

21



7-13 3 20 23
2-11 1981-1996
3 (11-33%) 2
(13-27%)24

(portion size) 25
2004



26




(Dietitians of Canada, DC)

DC

27
23

Tremblay MS, Wilms JD. Secular trends in the body mass index of Canadian Children. C.M.A.J.

2000 Nov 28; 163(11):1429-33

24
Tremblay MS, Katzmarzyk PT, Willm JD, Temporal trends in overweight and obesity in Canada,
1981-1996. International Journal of Obesity 2002; 26(4):538-43
25
Ministry of Education, Dietitians of Canada : Recommendations for School Food and Nutrition for
Ontario, Ministry of Education. October 20, 2004 ,
http://www.edu.gov.on.ca/extra/eng/ppm/dietcda2.pdf
26

27

(1)Ministry of Education, Dietitians of Canada : Recommendations for School Food and

Nutrition for Ontario, Ministry of Education. October 20, 2004 ,

(1)

22

1.
(healthy eating)

2.

3.

(learning and cognitive development)


(guidelines for healthy eating Canadas Food Guide to healthy eating)
1. 4


4
()
2.
(Guide to food
labeling and advertising) (CFIA)
3.

http://www.edu.gov.on.ca/extra/eng/ppm/dietcda2.pdf (2) Ministry of Education, Dietitians of

Canada : School Food and Nutrition. Recommendations for Ontario Ministry of. Education Regarding
Snacks and Beverages Dispensed by Vending Machines,
http://www.edu.gov.on.ca/extra/eng/ppm/dietcda.pdf
(1)

23

 Guide to food labeling and advertising (CFIA)

low fat non fat 250 .

( 2%)
175 .
, 20%
30-50 .
125 .

100%

125-250 .
1
40 .

( 3-4

250 mL

480 mg

480g

1

Grain based bars 30-40g

Muffins ,snack breads 55 g
Cookies 30 g, Cracker 20g

DC, guidelines for healthy eating

Canadas Food Guide to healthy eating

The Childrens Lifestyle and School-performance Study (CLASS)28

Nova Scotia
38%
80% CLASS
28

DALHOUSIE University, Backgrounder : Childrens Lifestyle And School-performance Study,

Faculty of Medicine, Dalhousie University,

http://communications.medicine.dal.ca/archives/newsroom/release66a.htm

(1)

24

 5
Nova Scotia
Nova Scotia Dalhousie and Acadia Universities the
University of Saskatchewan
5
Nova Scotia 11,300



a Harvard-designed nutrition survey

Intervention
intervention
intervention
CLASS
Nova
Scotia

5,500 70%
nutrition program 26%
3%
the Annapolis Valley Health Promoting School project
Coordinated School Health Program
Model the Center for Disease Control and Prevention (CDC) 29
intervention

29

Canadian Institute for Health Information, Obesity Rates Lower in Schools with a Comprehensive

Healthy Living Program, Canadian Institute for Health Information,

http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=media_22feb2005_e

(1)

25




30
Physical activity unit31

Public health agency of Canada the Canadian Society for exercise physiology
(CSEP) Physical activity unit

(Canadas physical activity guide for children)

30
30

Active School Contest 200532

2005

Quebec DO it for
you Active School
Contest 3,000- 100,000

30

Effectiveness of school programs in preventing childhood obesity: Amultilevel comparison. Am J

Public Health, 2005;95(3):432-435.

31
Public Health Agency of Canada, Physical Activity Unit : What is it?, Public Health Agency of
Canada, http://www.phac-aspc.gc.ca/pau-uap/paguide/intro.html
32
Kino-Quebec, Active School Contest 2005, www.santepub-mtl.qc.ca , http://www.santepubmtl.qc.ca/kino/jeune/ecole2005/ecoleactiveenglish.pdf

(1)

26

(1)

27



Parliamentary Office of Science and
Technology 8.5 6 15 15
1984-1994 4-12
0.6 1.7 1.3 2.6 33

(National Curriculum) 2
1. (Nutrition initiative)


4-11
2. (Physical Activity)

1,000
750

2

33

Parliamentary Office of Science and Technology, Childhood Obesity, postnote, September 2003
Number 205. http://www.parliament.uk/post

(1)

28

The Grab 5! A Model school food policy- a practical guide34



The Grab 5! A Model school food policy- a practical
guide

workshop

website


34

Sustain: the alliance for better food and farming 2002, A model school food policy a practical

guide, http://sustainweb.org/g5fp/index1.htm

(1)

29

GRAB5

Eating well at school 35

(Nursery) (Primary School)
(Secondary School)
GRAB5

35

Department for education and skills, Guidance for caterers to school lunch standards, Department

for education and skills, http://www.dfes.gov.uk/schoollunches/default.shtml

(1)

30

 MEND PROGRAM (Mind Exercise Nutrition Diet program)36

10

Fitness and
Happiness Program, Swimming and Studio Exercise

10 2003

Bromley
Lewisham 2005
INTERVENTIONS ON OBESITY 37
Health Development
Agency



1. Specific interventions on obesity ()

36

(1) London Borough of Bromley, Fun programme for Bromley fighting obesity,

www.bromley.gov.uk , http://www.bromley.gov.uk/
content/news/news_2005/mar_2005/fun_prog.html (2) MEND: Mind Exercise Nutrition Diet, Mend
integrates the essential building blocks of healthy living,
http://www.mendprogramme.com/programme.htm (3) P.M Sacher, P. Chadwick, J.C.K. Wells, J.E.
Williams, T.J. Cole and M.S. Lawson, Assessing the acceptability and feasibility of the MEND
programme in a small group of obese 7-11-year-old children , Journal of Human Nutrition &
Dietetics, Volume 18 Issue 1 Page 3 February 2005, doi:10.1111/j.1365-277x.2004.00578.x
37
Health Development Agency, Interventions on Obesity, Better health for children & young people
HAD Briefing No.3, June 2004, http://www.hda.nhs.uk

(1)

31

2. Physical activity interventions ()

5-11 11-15

intervention

3.Nutrition interventions ()

National Healthy School Standard

Nutrition standard for school lunch
Breakfast and after-school clubs
(School-based cooking skills clubs)
(Pre-school and day care settings)

(1)

32

5-14 21 10
1989

Waitemata Wellbeing Project38

38

Educating New Zealand, Well-Being in Schools Project, Educating New Zealand,

http://www.educating.co.nz/services/wellbeing

(1)

33

 Waitemata Wellbeing Project

1. The School Food Programme () The National
Heart Foundation Health and Physical
Education in the New Zealand Curriculum and Technology in the New Zealand
Curriculum

(1)
(2)
(3)
health promotion activities
Food and nutrition guideline
2. The Active Mark Programme ()
SPARC

3. The teacher professional development ()

(1)

34

3
1. (Nutrition)

(eating habit)

2. (Physical activity)



(Sedentary activities)



3.

(1)

35

(vending machine)



39














39

.
. 2548

(1)

36

40

1. //

Healthy weight 2008
Tackling

2.
(food dietary guideline), Canadas Food guide to healthy eating

40

(1)

37

3.
USDA School Nutrition Program



Team
Nutrition program

Coordinated school health programs

4.
School health
policies and program study , CLASS , Primary school
based intervention and risk of obesity
5.


School health policy
guide , Healthy eating policy development, Health promoting
school, Tackling: intervention model , School tuckshop
program (
),
Physical activity Unit (Canadas physical activity guide for children)

, The Grab5
, Eating well at school
, Intervention on obesity

(1)

38

6.

Food for health
Trim and Fit

7.
Active School Contest 2005
$100,000

1.
1.1 /
School nutrition program


1.1.1.

/


5 A Day program, The fresh fruits and vegetables program

1.1.2. ()



competitive foods

(1)

39






Ditch the fizz
School
Tuckshop Program

1.1.3.

1.2
Shapedown

1.3
(Nutrition education)

1.4


Kids Healthy food and
active guide. MEND PROGRAM

(1)

40

2.
2.1
Move it Groove it
Health club

The Active Mark programme

2.2



Physical activity unit

3.

Coordinated school health programs , Tackling

(1)

41

1.

2.

3.

(1)

42